We argue about everything except the things we don’t argue about at all. Somehow the fundamental business structure of US medicine is one of those things. It gets referred to, but rarely challenged. Here’s a long-standing challenge that illustrates, by being the exception to the rule, how some conversations just don’t happen.

Maybe there is no problem to discuss? Laugh. Health care costs are THE factor in all the budget trouble everybody likes to make their Hysterical Faces about. UNLIKE gas prices, which follow global supply/demand graphs, US HEALTH CARE costs are uniquely high here. Roughly speaking, we pay like TWICE what other industrialized countries pay for about the same outcomes. At this fact, the normally combative talking heads consistently fall silent and stare at their shuffling feet.

We have created a hugely expensive health system mess here, with costs out of control and actual data compromised. One quote from the story ought to catch your eye. “I think it is genuinely difficult to know what to believe in clinical research now....There are a lot of grubs crawling around under there.” The grubs are crawling. What is the treatment for that? More medicine like this story, please.